Assuming you’ve been informed that you need compression stockings, one of the essentials in understanding how these support socks work is the various ways they are used to treat different medical conditions.
However, a troublesome thought may come to mind, such as, “Does medicare pay for compression hose, stockings, or socks?” Of course, it is normal for people to ask these simple queries. This is especially true if you are in need of compression socks.
In specific circumstances, the Medicare payee will cover the cost of compression socks. However, it is still necessary to talk to your provider under what circumstances Medicare will cover your need for medical garments. Otherwise, you may need to shoulder the expenses for compression stockings.
1. Medical Conditions That Doctors will Prescribe Compression Socks, Hose, or Stockings
There are medical conditions that require compression socks. Some will be for therapy, while others will be for treatment. Most, if not all, venous insufficiencies are needed to use support socks, as well as lymphatic disorders and deep vein thrombosis (DVT).
Other conditions may also include:
- Diabetes
A person diagnosed with type 1 or type 2 diabetes may suffer from poor circulation and lower extremity edema. Diabetes Research and Clinical Practice say that diabetic socks or compression socks with diabetes specifications can help with edema without affecting the blood circulation at the lower extremities.
- Orthostatic Hypotension
This problem causes an individual to collapse when standing up abruptly. The fainting is primarily due to blood flow inconsistencies. Wearing compression socks will help ease this symptom.
- Venous stasis ulcers
These ulcers may be caused by poor blood circulation in the lower extremities, which may generally need injury care as treatment. The use of compression socks or stockings may be required to increase blood flow.
- Swelling
Compression socks can help reduce swelling in the lower leg. This is usual for those who suffer from congestive heart failure.
- Thromboembolism
Blood clotting can be avoided with the use of compression socks. Blood clotting occurs when blood pools at a specific blood vessel. Compression socks can boost proper blood flow to address this problem.
- Leg aches or tired legs
Aches and fatigue in the legs may be due to poor blood circulation, and using compression socks or stockings, can alleviate these symptoms.
2. Does Medicare Pay for Prescription Compression Stockings
Apparently, Medicare will not usually pay for compression stockings, socks, or sleeves. Since Medicare is federally controlled, specific provisions in the agreement have to be strictly followed.
There are four parts to the provision of Medicare:
- Part A: pays for long-term stays, essentially for hospitalization or admission in rehabilitation facilities.
- Part B: coverage of doctor's fees and medical expenses for durable medical equipment (DME) such as hospital beds or wheelchairs. Part B additionally covers a few immunizations and intravenous drug infusions.
- Part C: is otherwise called Medicare Advantage and is suggested by private insurance agencies. All plans should give similar inclusions to Medicare (Part A and B) and propose supplementary benefits.
- Part D: coverage for prescription drugs and medicines.
Initially, Medicare didn’t consider compression stockings or socks as durable medical equipment (DME). However, since there is a significant need for the use of support socks, it has been included in Part B as a DME only for specific illnesses and conditions or as prescribed by a doctor. With such an instance, Medicare will consider coverage for particular types of compression stockings.
Also, not all venous insufficiency is included for coverage. For one, treatment for varicose veins, circulation problems, and even prevention of leg ulcers are not included in the scope in Part B. This is because standard compression stockings don’t meet specific requirements under DME for it to have coverage under the provision.
Some Medicare Advantage plans might offer additional advantages that incorporate a stipend for over-the-counter (OTC) clinical supplies. Dual eligibles who additionally get Medicaid help might take care of solution pressure stockings under their standard advantages or a supplier’s stipend for OTC items. But for Medicare, there are specific regulations that do not include OTC products.
3. Does Medicare Part B Cover Compression Stockings
As stated, Medicare coverage of compression stockings will be a stipend if it falls under DME and is prescribed by your doctor. In the case of a patient who suffers from open venous stasis ulcers, there is a possibility that it will fall under Part B because it will be treated as an open wound care rather than a DME.
Basically, there are considerations wherein compression stockings or socks will be covered, but it will depend on specific medical conditions under a doctor’s prescription.
4. In Conclusion
For further clarity on Medicare coverage for compression socks, it would be best to contact them to know the details so that it would be clear and if ever a pair of compression stockings is needed, it won’t be too much of a financial strain for you. Otherwise, you may need to save up for compression stockings for future use.